A Simple Technique For Reducing Phalangeal Displaced Unicondylar Fractures In The Hand

Displaced unicondylar phalangeal fractures of the hand are unstable and require anatomic reduction and operative fixation (Shewring et al., 2015; Weiss and Hastings, 1993) (Figures 1). While there are multiple ways of reducing condylar fragments for either K-wire or percutaneous screw fixation (Geissler, 2006; Roche et al., 2010), these can often be difficult. Here we describe a simple method, not previously described. While gentle inline traction is applied with the proximal interphalangeal joint slightly flexed, to pull the finger out to length, a sterile rubber ring finger tourniquet (Judd Medical) is applied. The circular compression effect of the tourniquet reduces the fragment indirectly in all planes via a buttress force (Figure 2). There is no requirement for a pointed reception forceps, thus minimizing risk to neurovascular structures and further propagation of the fracture fragments. The fracture can then be fixed by the surgeon’s method of choice. In our patient, we used two 0.9 mm K-wires, replacing each wire with 1.2 mm screws. At 8 weeks post-operatively, the patient had full extension, with 85° flexion at his proximal interphalangeal joint. Radiographs confirmed the good reduction (Figure 3). It remains to be shown whether our results are reproducible by other surgeons, however, in our experience this technique is simple to utilize